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Health Starts With Her
So many women feel overwhelmed when it comes to their health—and unsure of what information to trust. Health Starts With Her is an unfiltered, science-based talk show hosted by Dr. Tara Shirazian, created to help women cut through misinformation so they can feel more informed, confident, and in control of their health.
This talk show is where we have the conversations that too many people shy away from with no sugarcoating or shame, just honest, science-based discussions to help you feel informed, confident, and empowered about women's health.
Health Starts With Her
Perimenopause Explained: Symptoms, Hormones, and What No One Tells You
Use Left/Right to seek, Home/End to jump to start or end. Hold shift to jump forward or backward.
Perimenopause can feel confusing, overwhelming, and often misunderstood— but you’re not alone.
In this episode of Health Starts With Her, host Dr. Tara Shirazian sits down with Cheldin Barlatt, CEO of This Is It Network, and Mary Pierce, former professional tennis champion, to talk openly about their experiences navigating perimenopause.
Together, they share what this stage of life really looks like—from the symptoms that caught them off guard to how they’re managing hormonal changes, advocating for themselves, and finding what works.
If you’ve ever wondered whether your symptoms could be perimenopause, this conversation is for you.
In this episode, we cover:
• What is perimenopause
• Common perimenopause symptoms (and the ones no one talks about)
• Hormonal changes and how they impact your body
• How to manage symptoms and feel like yourself again
• When to talk to a doctor
• How to advocate for better care
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Timestamps:
00:00 – Introduction
00:47 – Meet Cheldin Barlatt Rumer & Mary Pierce
02:00 – Symptoms of perimenopause (what to look for)
06:35 – What is Perimenopause?
07:15 – Where you prepared for this period of life
15:30 – “Is this normal?” How to know it’s perimenopause
16:30 – Navigating symptom changes
19:30 – Navigating doctors
20:00 – Advocating for yourself
22:15 – Treatment options based on lifestyle and goals
31:30 – Treatments that work
42:50 – Advice for women entering this stage
Why am I so tired? Right? Am I just getting that much older? Body pains, insomnia, weight gain, hot flashes.
SPEAKER_01Oh, my body's just kidding. Right? No, the body is not like the body does not lie.
SPEAKER_00I feel like it just doesn't get enough love.
SPEAKER_01It's not because I've become lazy overnight. It's not because I'm losing my all of those things that I was the negative self-talk that women tend to do to blame ourselves for whatever it is that we're going through.
SPEAKER_00Okay, listen. Hi, I'm Dr. Tara Shirazion. I'm an OBGYN gynecologic surgeon and the host of today's show. Today we're talking about perimenopause, a phase of life that so many women go through but rarely get good guidance on. We have two amazing guests today. We have Sheldon Barlett Rumer, she's the CEO of This Is It Network, and we have Mary Pierce, legendary tennis player and one of my amazing patients. I'm really excited to have an honest conversation and to share practical tools to help every woman get through this very difficult time of life. A big thank you to our sponsors today, Sumi Tomo Pharma, Serene Endometrial Cryotherapy, and Saving Mothers. We could not do this without you. Now let's get to it. A topic that I know you guys feel the same way, but it's I feel like it just doesn't get enough love, right? Like we need to be talking so much about perimenopause and menopause. And I think now's the time where some conversations are starting to happen. So just to delve right into it, what what are sort of been your symptoms of perimenopause? What have you noticed in regards to perimenopause? Sure. Start with that.
SPEAKER_01For me, it's the fatigue, right? As somebody who's grossly ambitious, constantly running. Why am I so tired? Right? Am I just getting that much older? Like, why do I need to nap? Why am I so much so tired in that way? And then the dreaded whiskers. I don't know. Did I get the ball this morning? Did I get them? As long as I got the ball this morning. The dreaded beard that was right. So all of these things are changing. My body is changing in such a dress. I didn't change my diet so much. But ever right? All of those things. Was it that the same for you? Oh, yeah, keep going. All of the above. And I'm just, I mean, I wanted to move. I went taking naps, sitting down longer than I had expected. I was like, maybe I'm just out of shape, right? Maybe I need to change this. Maybe I need to change my diet. And nothing was really changing work. Yeah. And all of the symptoms were.
SPEAKER_03Interesting. Well, yeah, those symptoms as well. And it's, I think, I think that starts to happen with trium menopause. And we don't actually know that that's what it is. And I think like you were saying, it's like, gosh, I'm more tired than usual. What's wrong with my like need to get some blood labs done? Am I loading something? Like, or I'm just, you know, doing too much or I'm not sleeping enough. But like for me, it was um, yeah, so like the fatigue, um, body pains, body aches, um, joint pain, um, insomnia, right, weight gain, yeah, hot flashes, feeling hot even all the time. Right.
SPEAKER_00Like I used to be like time. So that is the crux of it, right there, right? There are so many symptoms. Right. Right. There's not like one or two symptoms. Perimenopause has like over a dozen different symptoms. Over like two dozen different symptoms. Yeah. Insomnia, sleep, hot flashes, um, brain fog. That's another one. Exactly. Women of a certain age are like, we can't remember that word. Exactly. That proper word for what that is. Like that is a mug. Right, right, right. Totally.
SPEAKER_03I can just lose my train of thought as I'm saying something like a little bit more forgetful or not remembering things, and just like, yeah, that kind of stuff as well. And it's like, you don't know.
SPEAKER_00Right, you don't know. And I think that's a really big issue, right? Because women have symptoms, but they don't know if those symptoms are necessarily perimenopause. And what is perimenopause, by the way? Is it an age? Is it, you know, and so perimenopause is defined literally as like up to a decade, up to a decade before menopause, where women have symptoms that are related to kind of that ovary function declining. And so they feel things like brain fog, they feel hot flashes.
SPEAKER_03And I agree with that. And heavier, heavier periods too. Heavier periods. Like abnormal for me, like starting to get like more, more like heavier and then abnormal, and yeah, that as well. Absolutely, absolutely.
SPEAKER_01And I was like, I got this down in my 45th year of life. Why? But as now I'm 48, and so it just keeps changing. And I think that's hard too, because not only is it a large amount of symptoms, they're all different and they're all ever changing. Right. So to get a handle on one and then here pops another.
SPEAKER_00Right, exactly. And some women experience perimenopause, you know, at 35 or 40 because literally it's up to 10 years before menopause, which is defined as a year without periods. So that is the transition. Menopause is one year, no periods. Okay. That is that sort of the I think a lot of women don't know that.
SPEAKER_01Give me a time.
SPEAKER_00A time where one says, okay, yeah, I'm in it. I'm in menopause. But you know, interestingly, like what's happening now is women are going on HRT, or maybe they're using some other medications, which you know, we'll get to, but they might not know when it's been a year with no period. Like they might have some bleeding or spotting on the treatment regimen that they're on. So it might be harder to technically define it as a year without periods. Yeah. Just to make it more complicated. Just to make it more complicated.
SPEAKER_01And even what you said about the perimetopause being a 10-year window, that's not a window. No. That's a garage door. Yeah. That's not, you know what I mean? That's not a small window. 10 years. Yeah. You have a span. But I think that even when we were younger, very much younger, all of our friends were getting their periods at various times, right? I had friends that had periods at 10, and others didn't have it until they were 15. So is it kind of like the same? Everybody's so different than that.
SPEAKER_00I think it is way wider. Like it's more broad because most girls, you know, there is a range to your first period or menar, right? It's like, but it's more like nine to 13 with outliers being sort of beyond that. But perimenopause is just defined as like the symptoms related. So that's a good indicator.
SPEAKER_03So like when you start having like these different types of symptoms that aren't normal that you haven't had before, it's good to kind of know, okay, now this is like the perimenopause starting, but then you don't know how long that's gonna last until you're in menopause.
SPEAKER_00You kind of don't know. And so did you guys feel prepared? Did you feel like your girlfriends were talking about it? Or you know, not me.
SPEAKER_03Not at all, no, not at all.
SPEAKER_01We knew it was coming, right? We knew it was coming. The changes, it's coming, but in what form did it come? Because again, I I equated it to lifestyle changes or things that were going on in my career, or I have busy children, and so it's just me. It wasn't part of this natural progression of my life. It was more based on what I was doing or not doing to take care of myself, right? And so I was like, oh, you know, I should be working out more, I should be eating better, right?
SPEAKER_03Or how's my sleep hygiene? Why am I not sleeping at night? And then you try, and like you just like try all these things, and you're like really trying hard. Right, really trying hard. It's like not really making a difference. And you think, well, what's wrong? Like, what's wrong? What's wrong with me? Why can't I do this? Why am I not able to do it? You know, I feel like you know, I'm with my tennis background, you know, very disciplined and lots of sacrifices. And so it was just like, gosh, really hard because you're trying really hard to get better in all these different areas where you're seeing changes and things that aren't normal, but it's like it's not really working.
SPEAKER_00It's frustrating. Right. Women tend to kind of internalize their symptoms and say, okay, well, what am I doing wrong? What did I do? Like, yeah. Like, what did I do to cause this? What can what can I change about myself to make it better? Exactly. You know, we hear that with perimenopause. I hear that with almost every women's health topic and conditions. Everybody is like, what am I? I must be doing something right. So it's definitely obviously not true. And I think that also women um feel like it's stress. Like all of these sentence are stress-related. Yes, which is you know, which is to your point, like, okay, well, it must be that I'm under a lot of stress, so that's why I can't sleep, or I'm having hot flashes. So it really does prevent people from getting care earlier or exactly.
SPEAKER_03Yeah, exactly. Like you said, like it could start at 35, which we think, gosh, that's really early. But if it does go on for 10 years or so, then okay, you're about 45 or so. But still, I think it's really important. And one of the things that you were saying earlier is how, like, did we feel prepared? Was I did I feel prepared? Like, not at all. I mean, I think for me, all I really heard about was menopause. Yeah, right. And then just like one day you're just not gonna have a period anymore, and then that's it.
unknownRight.
SPEAKER_03Literally. I was like, so it comes. And I was like, okay, fine, that's great. And I thought, oh, not having a period anymore is gonna be wonderful. Absolutely wonderful signs, yeah, right. And but that was it. So, like, not prepared for any of these symptoms at all that I was having, and so trying to go to like different doctors and different things and like nutritionists and like all kinds of different modalities and things that you could just like try to think to help fix that one isolated maybe issue, you know. Um, and just really not getting the results that I wanted and just really being frustrated. So I was not prepared at all. And that's why I think this is so amazing to be able to talk about it and to help the other women out there that are going through these things and not knowing what's happening and to be able to help them. Absolutely.
SPEAKER_00And you said something before, Mary, which I think is so true. People like to paint, paint it as you're having these hot flashes that like kind of come and go. And some women do have hot flashes, but other women are just hot. Yes. Because I myself have experienced it. So I'm just like, I'm just hot in the center. All the time in my feet center.
SPEAKER_01I'm sweating in the shower.
SPEAKER_00It's not it is not a flash. A flash is defined as like 30 seconds, it comes and goes. No, I'm just there to stay.
SPEAKER_03Totally. And so I, you know, growing up in Florida, yeah, playing tennis, being outside in the heat, the hottest, like one of the hottest parts in the world in the summertime, and just used to the heat so much. And just, you know, you know, I have the AC on and around 75, 74, you know, in my place. And like now it's 70 degrees, like all the time. And at night I want it at 65. And then people are like coming in and they're cold. And I'm like, are you cold? Like, this is just right. Like, why is it perfect? Like my temperature at home, the thermostat is like colder than it used to ever be all the time, you know?
SPEAKER_00Absolutely. So I yeah, so I think there are these myths that people don't really feel ready for. Sure. Because even the way we define it and talk about it, it's still called a hot flash. So if you're not having one that like comes and goes and it's all you're like, wait, is this the same thing?
SPEAKER_03No, I'm just laughing because I remember I was at the airport once in France and I was flying, and then like I was walking to the airport, everything was fine, and all of a sudden I'm in a shop looking at some stuff, and I just start sweating. Sweating. I'm like, man, it's hot in here. And I'm like, do they not have the AC on here or something? And I'm like, is everybody else hot in here? Is it just me? You know, like I'm the only one sweating. It's just you, it's just you, you know, it's just you.
SPEAKER_00And so we mentioned, like, okay, so then who do you talk to about this, right? So one thing that I hear a lot is, you know, women trying to ask their mothers. So I don't know if you guys first tried to broach the conversation, like in your families with your moms, if your moms are.
SPEAKER_01I mean, I'm for sure. So I'm an immigrant. I was born in Sierra Leone, West Africa. I come from an amazing West African family that loves to keep secrets. And so when you're talking to your mom, oh whatever happened to Aansi, oh, you know, she passed. What did she pass from, mom? Like what are the details? And they kind of graze over it in conversation. And so as you get older, you get to have these conversations and you get to talk about it, right? And the more I start talking to my mother, the more we start really chipping away. But it wasn't really an open conversation. Happy birthday, how are your hot flashes? That wasn't the dialogue, right? It was more like if there's something wrong, you come to me. But oftentimes with women, how bad does it have to be before you ask for help, right? We are the coping gender, right? We will just deal, right? We will just derobe some places, right? But it has to be severe before we ask for help, right? Or have a conversation. So that's why it's true. That's so true.
SPEAKER_03It doesn't even need to be. It doesn't need to be. It doesn't need to be. And I think that's so important what women need to know. You don't have to be suffering. You don't have to be going through all these symptoms. Like, life can be different, it can be great, you know, for sure. But like, I think just you know, touch on what you were just saying, um, with my mom, you know, being from France and raised and and um actually grew up in a convent and went and went to school and lived in the convent with the nuns. And so very um, I don't know, didn't talk a lot about much things, right? You know, and so um, you know, just remember about you know, one day you're gonna get your period, and that was about it. And then I told my mom that day when it happened, and then after that, like there wasn't much talk about anything else. Um so it's kind of tough, yeah, you know, when you don't have that like preparation to understand.
SPEAKER_00Yeah, exactly. And I think that's one of the big goals for this kind of forum. Yeah. Because to your point, yeah, even things like when you first got your period, you know, in those days, especially decades ago, um, no one talked about getting your period. Now there's more conversation around 100% like girls getting their period and being prepared and being prepared in school, etc. Yes, yeah. Same with menopause, right? It's no one was talking about it, and now those forums are kind of opening.
SPEAKER_03Yeah, definitely. And my mom, I was just thinking, you know, she actually had a hysterectomy when she was like 45. And I remember talking to my mom, I was like, Oh, well, what happened? And she's like, Oh, I don't know. They found something they didn't like, so they just took everything out. And I was like, What did they find? She's like, I'm I'm not sure. I was like, What do you mean? You know, it just passed in the street. So, like, that's one of the things. Like, did my mom actually need to have a hysterectomy at 45 or not? I don't know, but like, and so she wasn't educated, she didn't ask any questions, she was just like, Okay, yeah.
SPEAKER_00Let's talk about what happened when you went to the doctor, which hopefully you did go to the doctor. So that's number one. Yeah, did we go to the doctor? And if so, when you went there, what what were the specifics of that encounter? What did the doctor say? What did they say when you told them their symptoms?
SPEAKER_01I have a really great relationship um with my gynecologist. So preparing is usually not that heavy because I just kind of go in there with a laugh and we talk about where it is that I was versus where it was it is that I am. And so we were able to go through all the benchmarks and the things that were going on with me, all of the various symptoms that were going on with me. But I fear that those symptoms have changed, evolved, and are slightly altered. So prepping for this particular appointment, which is happening in the next couple of weeks, the notebook looks a little different. I have far more notes to be able to share with her. But I recognize that the majority of women aren't as comfortable with their physicians. They haven't found that soundboard to go up against, whether it's their general practitioner or their gynecologist. I'm lucky that both of them are lovely, but both of them also equally being female. So the conversations and about the same age. So we're all kind of going through it. And they'll tell me what they're going through, and they'll talk to me about their hot flashes and what they're particularly doing. So I think those conversations are happening not only on these couches, but in the exam rooms as well.
SPEAKER_03Yeah, definitely. So for me, it's it was interesting because um, you know, my periods were like clockwork. So every 28 days, five days started light, heavy, light, and then was done. And then so it started to be a little bit early, a little bit late, um, heavier. It was one of the big things for me. And then the insomnia were like, I think the big, the beginning, the beginning, like big symptoms. So I went to the gynecologist and I had a great gynecologist. I had like the only one and only, like pretty much my whole life. Then she retired. Oh, and so then I know congratulations. Yes, wish you all the best, but uh please don't stop. Right. Um someone else came in, and so just re-establishing that. And so that actually happened when um the second, I guess, gynecologist came in, um, who I just kind of met and started working with. And so we did an ultrasound, and so she's all okay, you have uh some fibroids, and they're not that big, so you know, that could possibly be causing more of the heavy bleeding. And if you are bleeding like really heavy, then just take this prescription medication and to not bleed as much. Basically, that was the main thing. So I was like, okay, I'll think about if I want to take the medication because you know, with playing professional tennis and being an athlete, you don't want to take it. The the least amount of medications that we can take, the better. But if it's necessary, definitely, you know, we'll take it. And then I guess with the insomnia was, you know, working with functional medicine doctors, working with nutritionists, working with um, you know, I like to try to do everything as natural as possible. There was like, oh, well, melatonin, maybe that'll help you with sleep, or some magnesium, or um, you know, get your blue light blocking glasses on at night. Don't watch, you know, any screens two hours before you go to bed. Like all the sleep hygiene things. And I'm like, okay. I'm trying. You know. Um, so yeah, I definitely um went to various doctors and you know, doing the blood tests and trying to see if there's something going on there. I really just tried to look at everything without leaving any stone unturned to see like what could I possibly do to feel better, you know?
SPEAKER_00I feel like that's it's such a common theme, honestly. It's such a common theme. Women want to do as much sort of natural treatments and remedies, which is great. Sure. Um, I think the thing that sometimes I battle with as a as a GYN is you also want to do the thing that works for you, right? Because how much time and effort and and money do we spend on like supplements and blue light glasses and you know, all these things that you know, that at the end of the day probably are not quite as effective, like won't move the ball in the way that, like, I guess that's a tennis metaphor, maybe no, massive body um as you know, a medication sometimes. Like it's it's very variable. And I actually think it's also the tricky part is it's very nuanced and it's very personal and it's very individual, right? Like what works for you may not work for me, may not work for Sheldon. Yeah, but but there probably is some combination that will work for you in a very effective way. So I think finding the right doctor, right? And being able to like advocate for yourself and them hearing, he or she hearing what you have to say and giving you good feedback is like essential. Totally. So 100%. Yeah. So how do you think women advocate for themselves in a way that around this?
SPEAKER_01I think that it's this. I think that it's not knowing what you don't know and being really empowered to go seek out the information. We were just talking about all the trial and error, whether it's the glasses, whether it's the diet, whether it's the workout, changing your sheets, all the craziness, right, that goes along with it. Some of it works, some of it doesn't. But the time frame within which it takes and the discomfort that you feel during that time not only is physical, but it's mental. Right, right. It's really trying to on you. Am I going crazy? And you just can't keep up with your body. That's what it kind of feels like to me. And so when I am doing the research, when I'm, you know, but there's a flip side to that. There's the Googling in the wrong direction. Right. Right? There's and how do I utilize what I search out? Because I believe that there's a reality in that. They're going to Google, they're going to look it up. But how do I use that as a guideline of what I take in this notebook to my physician? Yeah. Versus the full picture. And I think that has helped me. I'll Google, but not ad nauseum and not take it all on face value. I'll take it and then go to a trusted source.
SPEAKER_03Yeah, yeah, yeah. Definitely. I think it's important for just women to speak up and women to talk about it and women to ask questions and you know, not to be um embarrassed or ashamed. And I think it's really important, you know, like you were saying, you have a great relationship with your gynecologist. And so I think it's important to feel like the the practitioners, the doctors that you're working with, that you believe in them, you trust them, that they're competent, and they're gonna give you the proper diagnosis, the proper treatment, and to be able to go there like you come prepared. You know, you do your research, you write your questions down, and just say everything. You know, just say exactly how you're feeling, exactly what you're going through, um, and all of your symptoms. And it's important, I think, to talk about it and like we're doing today to talk about it to help other women to understand oh, you're not alone, you're not the only one going through it. We've we've Good going through it. So it's just part of the the transition. And so I think that's really important. Talking about it, asking questions, reading, researching. Definitely.
SPEAKER_00It's a partnership, right? Like you want to come, you want to come to the table, kind of laying out exactly what you're feeling and going through. Um, and sort of helping in that partnership to also teach your physician what you need, right? What is going to be most important to you? What are the most important goals? Like sometimes on a long list of things, we might not be able to make every single thing go away, right? So actually knowing that like sleep is really important and you know, being able to go to work and get like your work done. So maybe brain fog is really important. Energy bleeding is a very important perimenopause symptom. Like if you are bleeding all the time, it's going to create a lot of anemia that's going to really negatively impact your quality of life. Like, I think people underestimate how much anemia can affect you, right? All of these things together, I think, in that partnership help you arrive at that. And my other really big thing is, you know, social media is great, but it is like a little snippet.
SPEAKER_03You gotta be careful. You know?
SPEAKER_00And even as a consumer of health information, right? Like I'm on Instagram looking at what people are posting, and sometimes I'll look at a post and I'll be like, I didn't understand anything. And it's meant to be a medical post. 100% like 100%, like hormone replacement. You know, does anyone know what what type of hormone replacement, how much hormone replacement, what dosing of hormone? It is very nuanced. Yeah. And there are sort of lots of options, even in that one category. So if one doesn't get you 100% where you need to be, there probably is an alternative in there that will. So just making sure you keep up that dialogue with the physician.
SPEAKER_01Yeah, I definitely. What is really interesting and what you're doing, and part of this conversation that's so important is the language, right? Again, if I can't understand what you are saying, yes, people usually just are like, well, good night. Right. And shut down the computer, right? Like if I can't pronounce it, if I don't know what it means, if I don't have a direct connection to it, I think the glossary of terms, I think understanding what the glossary of terms are, because oftentimes we graze over it simply because we can't even pronounce it. We don't even know what it is, that can't affect me, that's not mine, it doesn't belong to me. But if we can start owning these words, right, that are such an integral part of our body and the hormones that go along with it, I think that there's a sense of overwhelmed, you know, you're in an overwhelmed state, you're already not feeling your best. And then now you have to comb through all of this information that's just not clear. Right.
SPEAKER_03It feels so we love your content just because you really give it to us in a very making it simple, easy to understand, and also educating women. And that is power when you have to be able to do that. Yeah, that is power and information.
SPEAKER_00We each want that power right over our own body. So definitely that's what that's what this is all about. So let's talk about the turning point. Okay. We love turning points. Yeah, yeah, yeah. Like that aha moment that when you when you figured out along with your doctor or on your own, figured out the set of tools that helped you feel better. Yeah, exactly.
SPEAKER_01Yeah.
SPEAKER_00So what was that turning point?
unknownYeah.
SPEAKER_01For me. Well, for me, I'm still in it. I'm I'm consistently turning. I'm turning at this moment. I'm turning. I'm turning. Um, I think that it was very much realizing and coming to terms that that's what this is, right? It's like, it's not because I've become lazy overnight. It's not because I'm losing my all of those things that I was the negative self-talk that women tend to do to kind of justify or to blame ourselves for whatever it is that we're going through. When I was able to have a mature conversation with my physician and get to the other end. Oh, it is, it's my time of my life, right? That I'm in, then I could navigate it differently, right? It wasn't a series of different things that were wrong with me. I wasn't completely, as I used to say, falling apart. I'm not falling, am I falling apart? No, it was one thing. Falling apart and going crazy.
SPEAKER_03What's happening?
SPEAKER_01Going crazy and sweating all at the same time. Yeah. Right. Um, it was part of one thing that had all of these different symptoms. When once I was able to have that conversation, things really began to change. And then I backed that up with research and then supported it with a conversation.
SPEAKER_03Yeah. I think it just helps so much, you know, to talk about this and for other women to hear this and to see this because it just makes you feel so much better. Sure. You know, to think, gosh, you know, I'm not alone. Like, I'm like, oh, you went through that too. Okay. And then, like, how are you feeling better? What's the sign? What did you do? Send me a link, right? Yeah. So, um, so for me, it's um it's great because it's it's actually been recent. Yeah. Um, I'm so grateful and I start to get emotional when I think about this. Um so I had a really hard time this summer with a lot of extreme bleeding, um, where I couldn't actually leave my house for like seven days. And um, wow, something's wrong. Something's not right. I need to get I need to get this checked, I need to get this fixed. Um so I went to the gynecologist in Florida, and um the second one had retired. Only last only for two years she was there, and then now I was the third one. So here I am meeting another brand new gynecologist that never met before and hadn't didn't know me and hadn't met me before. And um, so yeah, another ultrasound, and then showed, oh, okay, your fibroids have doubled in size. Um you need a hysterectomy. I don't know, it's just I was just shocked. I didn't expect that. You know, it's like dropping a bomb right there on you, you know, within like five minutes of meeting of meeting the doctor, the gynecologist. And I thought, okay, I need to process this, let me just take this in, let me gather all my information and let me start to inquire and just see if this is the solution, you know. Um and so I reached out to the WTA, the health department there, and I also did my research. Shout out to my colleague Venus Williams, who is a patient of yours, Dr. Sherazian. Um so, you know, obviously knowing Venus and Serena since they're little girls before they even played professional tennis, I'm just so grateful. You know, I am so grateful to Venus for speaking out. And so that's why it's so important for me today to be doing this here today, because I know how much it helped me, you know, for Venus to speak out about what she was going through and how tough it was for her and what she, who she saw, where she went, and how she got it solved and her solution. And so I was like, okay, I need to see Dr. Sharazian. I am I need to see Dr. So I I was at the US Open for some meetings and for work, and I was like, I need to see Dr. Sharazian. I just I just need to see her. And um, so I'm so grateful that you're able to see me and um during that time that I was there, and um yeah, I just I just felt um immediately that I was in good hands. Yeah, you know? Oh, I want to give you a sorry, I cannot lie, I gotta give up.
SPEAKER_00Thank you. Oh, that's awesome. I so I so appreciate you.
SPEAKER_03Yeah, I just I just thank you so much for being here. No, it's it's a pleasure, like I said, you know, like if Venus didn't speak out, I I probably wouldn't have known. How would I have known? Okay, yeah, I can go online and I can Google and you know, obviously your name did come up as a fibroid specialist, and um, you know, and so um I and you know, I I definitely wanted to to see you. And so when I came to see you, you're so thorough, and just with all the examinations and all the questions, and just talking and listening and telling, you know, getting to tell my story. And not a lot of doctors actually take the time to just sit with their patient and look them in the eyes and talk to them and listen to them and ask questions. It's always a lot of times so fast and in and out, and like you feel like they just don't have time. And it's like, you know, for something this important, you need to feel that you're in good hands, that you're with a doctor that cares, that is competent, that knows what they're doing. And so, you know, after our appointment and speaking with you, I I definitely felt totally at peace in my heart. And I'm like, okay, Dr. Shrazian knows what she's doing, and uh, she's helped Venus in such a tremendous way, and um, so I knew that um it was what I needed to do, was the next step was you know, to have the procedure. And and with that, yeah, um, we spoke about all of my symptoms, of course. Yes, and my perimenopause symptoms and everything that's going on. You're like, oh, you know, heard this before. And I was also having some thyroid issues to on top of that. Um so basically you're getting the thyroid fixed, sure, and then this tiny little patch. Yes.
SPEAKER_01The estradiol patch on my list. My tell me. You don't have one? Oh no, I don't have it.
SPEAKER_03Oh, I don't have one yet. Okay, it's on the list, it's in the notebook. Let me tell you, you need one. This is gonna change your life. Yeah, change my life? Yes, change my life. Okay, listen, it changed my life because literally I started using that patch. Yeah, and it's like now I sleep. I feel normal.
SPEAKER_01It's the chat.
SPEAKER_03It's like every symptom that I had was like all of a sudden, like, oh, I just feel normal. Like I'm just like, this is how I'm supposed to feel all the time. This is how I used to feel. I just feel good. It's not like, oh my gosh, I feel like amazing before I felt terrible. No, it's like right feel good. Do you feel balanced, do you feel calm? Okay. A lot of time there's can be like this almost semi, I don't want to say like frantic, but just inside all the time. Like you're just like, gotta go, you're overwhelmed, you got this to do, and you're stressed out.
SPEAKER_00Oh, I love that.
SPEAKER_03And now I can just like okay, I'm relaxed, I'm clear in my mind, my energy is good, I sleep well.
unknownThank God. Yeah, nobody loves that.
SPEAKER_00100%. Oh my god, there's so much impact. There's so much impact. There's so much, I mean, I'm honored by the way. Thank you. Thank you for sharing that. Thank you for being here. It is truly my honor.
SPEAKER_03Thank you for having me.
SPEAKER_00It's a pleasure. I hope this is a good idea. This show, yes, is for women. 100%. It is it is for them. It is to help them understand that every woman deserves good quality health care, and that their their own health care is nuanced. So you do need someone to really listen to all the symptoms and to really help you navigate those symptoms together. And I'll tell you why. This is actually the perfect example. If you go on HRT, but you have heavy bleeding and abnormal bleeding that we don't address, you're gonna bleed more. It's going to just exacerbate you know, your bleeding. So we actually do need to treat the bleeding in perimenopause because the bleeding can get out of control. And you're not alone. 80% of all women not leaving your house for seven days.
SPEAKER_03Seven days because I had such bad bleeding and clots. Oh, yeah. And when a clot comes all of a sudden, you have to go to the bathroom. Yes. And if you don't, like you know, you end up changing your clothes like how many times a day, two, three times a day. It's hard.
SPEAKER_00Yeah, it's really, really bad. So, and the problem is if we don't treat that, you're not gonna get the most out of the HRT because you're gonna be bleeding, and you're really not going to get see all those benefits as you would if we first treat the bleeding. So, I actually think it's super important to treat perimenopausal bleeding. And I love to treat these two things together because I think so many women suffer with both. And we treat the bleeding in many, many ways. We have good medications that can reduce bleeding that kind of just will um be like a bridge to menopause. We have procedures, endometrial like cryotherapy in the office. We have radio frequency ablation. You know, we have lots of tools in our toolkit to treat the bleeding. Even if you don't want major surgery, you can have your bleeding treated, right? And I think that's what a lot of people don't know. Exactly.
SPEAKER_03And this is exactly what I'm saying, and this is actually what I felt. Like you just have so many tools in your toolkit that um are so beneficial for women, and it doesn't have to be copy-paste, cookie-cutter, like hysterectomy or whatever it is, like you know, solution. There are so many other ways to various ways and tools to treat these symptoms, you know, and one might work for one, it might be something else for another, but there are ways to treat this where you can actually live a normal life again and feel good. Yeah, yeah.
SPEAKER_00And so let's talk HRT then we've got right go ahead.
SPEAKER_01I wanted to say something because I think a lot of women think that the gynecologist they have is the gynecologist they have to have forever, right? So because you've been going to them since you had your first job, right? Oh, yeah, like you don't want to offend. You don't want to move, you don't want to offend again, which is promotion by the way. It's crazy. You're not listening to the best match, right? And so if the gynecologist you're currently going to does not have enough tools in their toolbox, maybe that, right? There's a change. It's a change. So that's what I'm saying.
SPEAKER_00I think right now we're saying we give you permission. Yes, 100% because I've seen that so many times. So many times. I've actually had women be like, but you're not gonna tell my gynecologist. Right. And I'm like, no, I'm not gonna send them a letter, I'm not gonna call them on the phone. You know, I think people are which is lovely of women, right? They don't want to offend anyone, they're just want to be nice to everybody. I get it, but no, but no, absolutely not what's best, not in the view of your health.
SPEAKER_01And I think that that's really an important thing to let we're giving you permission to go find somebody not only that has the tools, but listens to you. I think that's mentioned is so important that asks the questions, that really cares, that is listening on the other end of what is going on. Yes, I think it's just such a wonderful thing. Uh-huh. Yeah. 100%.
SPEAKER_00And second opinions are good. Yes. Definitely always tell women to seek out second opinions. I think it's very, very important. Yeah, definitely. Get an idea of what else exists to be sure you've made the right choice. Exactly. You know, it's like the choice in a partner that maybe is. Right? Like, of course. Choose the people that help you get where you need to go. 100%. Exactly. But I have to talk about HRT because obviously HRT has been in the press a lot. Everyone's talking about it. Um, I will start by saying that again, healthcare is nuanced. HRT might not be the best choice for every single person, right? And there might be reasons that people shouldn't use it. Um, but I think for many, many women, it is a very good and safe choice. And I think that's why we're hearing that so much in the media, is because it used to be thought of as a very negative choice, right? That that like it could cause cancer, etc. And I think that health dialogue was the one that everyone heard, and so many women were fearful. So now we've kind of swung the other way, where you hear so many advocates saying, no, get on it, get on it. And and I mean, I'm not pushing anything, but I do think that it offers benefits to many women. Some of the most specific benefits that help the majority are sleep. Sleep an estradiol patch with a you know prometrium progesterone tablet, if you have a uterus, can help you sleep and it can help you feel more just regulated and hormonally kind of calm, which I think is what Mary's referring to. Yeah.
SPEAKER_03I think that's important to even mention this here. Like for some women, like what is AHRT? Yes, and what are my options in HRT and which one is gonna help me with what? Exactly.
SPEAKER_00Yeah, so just as a very brief thing. Okay, HRT is hormone. I know. All right, there we go. HRT is hormone replacement therapy. So for HRT, the biggest studies from the WHI study was oral estrogen and progesterone. So it was a combination oral pill. And the women enrolled in the study were older when they started the HRT. And even in that study, um, they really didn't show a statistically significant difference in breast cancer risk between the group who took it and the group who didn't, but it sort of got really inflated in the press, and everyone started talking about it being a cause of breast cancer. Like in a nutshell, that's essentially what happened. Got a bad rap. Got a bad rap, exactly. So that was oral. So now it has shifted to more the patch plus the more natural the patch is estradiol. Yeah, the patch. And it's it's more natural estrogen, so it's estradiol. So it's become sort of the favored combination now. Um, but they're still oral.
unknownOkay.
SPEAKER_00There's also estrogen gels. Right. I've heard of gels and creams. Yep, gels and creams. There's also um a patch and an IUD as the delivery method of the progesterone. So there are a number of different combinations, and something different might work for you know each of us. Um, but I would say the first one to start with, the more favored one is probably the patch pill. Yeah. Just because it's a little bit easier, it's twice a week for the patch, it's you know, usually daily for the pill or two weeks out of the month for the pill. So it's it's a little simpler than some of the other methods to start with. And I can tell you, even as an OBGYN, right? When I I called up my really good friend who's a GYN, you know, and um one day when I was so hot, it was literally 48 hours. I was so hot, it was unrelenting heat. Okay, and I called my friend and I said, What is happening? She's like, girl, you need an estradiol. What are you doing? What are you doing? You need to get on the patch. Yeah. So I think it is probably the most favored combination. But there are lots of others. Of course. As we know, there are also holistic management options like evening primrose oil is one that's been around forever. Um, there's also Paxel and peroxetine, the antidepressants can work to reduce hot flash rates in about 60% of the time. So it can help. Okay. So there are also alternatives. And then there's a whole host of other newer medications that um are targeting various aspects of menopause that are alternatives. But I do think that the HRT combination offers you the most with the least number of things, which is always a thing we should be. It's always right. Yeah. Yeah.
SPEAKER_03From my experience with the patch, um, gosh, it's just super easy. Yeah. You know, you put it on, you know, specific areas like around your abdomen area, and it's just, you know, I was a bit concerned of like, oh, is this gonna rub with my clothes? Yeah. Or what about when I shower? And all of that. It's like you put it on, you don't even know it's there. Sometimes I'm like, is it there? Where's it? Yeah, it's still there. It's just this really small, like rectangular shape, transparent patch that you put on. You don't even see it, and you don't even feel it, you don't feel anything, and you shower with it, you live with it, you do everything, just kind of completely normal. It stays on, then you just change it twice a week, and like that's it.
SPEAKER_00And there are lots of doses to it too. So, like, you know, so these are sort of the nuances. Yeah. But but yeah, I think it's probably the one that works for the most. Yeah. That's what I would say. But but yes, everyone, there's lots of choices. So if one doesn't, you know, resonate, you can have it, you can choose something different. But I do think there's an answer for you. Like there's something that will address your symptoms. Absolutely. There's hope for you.
SPEAKER_03There is hope.
SPEAKER_00There's an answer, there's a solution.
SPEAKER_03Perfect.
SPEAKER_01What do you want everyone to do? We see you, girl. We see you, girl. We see you, girl. For me, it's like pay attention. Yeah. Pay attention to your body. Your body is not lying to you. Sure. Pay attention to your body, right? Oh, my body's just kidding, right? No, when your body is not playing, the body does not lie. And then utilize that to pay attention to the changes that are happening and bring those changes to the attention of your physician. Be prepared. Definitely. Yeah. I would say, don't wait. Don't wait.
SPEAKER_03Don't wait. Don't wait. Just why, just why wait. Why through? Exactly. Like, just why wait? Why like try to like just get through it? Or, you know, I mean, just you don't have to. Like, just don't wait. You start feeling those symptoms, go to the doctor. Yeah. Ask all your questions, get the treatment. And like you said, you know, try it out. If maybe sometimes it might need a digestment of dosages or a mix of like whatever, you know, HRTs, whatever the solutions are. There's plenty of tools out there. Don't wait. Just go get it treated.
unknownYeah.
SPEAKER_03You don't have to live with all of those symptoms like that. Absolutely. I love that. Yay. Wow.
SPEAKER_00It was so great having you ladies on today and talking to you. Oh, it's a pleasure. Yes. So encouraging. And I know that viewers will learn so much from your stories and what you share. So thank you. Thank you, Charlie, for what you've shared. It's been so good.
SPEAKER_03Dr. Tresian, you've just been amazing. Yeah, it's just so important. Yeah, it's so much fun.
SPEAKER_00Anytime. Thank you for watching today's episode. I hope you're walking away feeling a little more empowered. The lessons are simple. Know that you have options, ask questions of your doctor, and just know that you have a community of people that will help you navigate this difficult time. I want to sincerely thank our sponsors, Sumi Tomo Pharma, Serene Endometrial Cryotherapy, and Saving Mothers. We couldn't do it without you. This is more than a show, it's a community. And we want to keep the conversation going. Stay connected to us. Share this episode with someone you know. Ask questions, and stay tuned for more episodes. We'll see you next time.